 yn oed yn flog. Felly yes yn fweld yn gweithio gwyd涵 credits Cymru ond rwy'n gweithio wnaeth na hwnnw i'r ym世id draws bydd eraf syniadol efallai rydyn ni'n gofynie i'r gwahodd i'rogi ar gyfer ychydig ym Nesaf, ym Nghymru, a lle hi'n gwybod eu bod hynny o'r tîm o'r gael credits Cymru roi ddangos o'r gael ac oedd hyn. Felly先 Lywodraeth Cymru, mae'r gael ymlwyfynol ar gyfer y Felly, NY stands for the National Institute for Health and Care Excellence and this is an organisation that is run by a load of professionals and what they do is they basically they want to improve the outcomes for people within the NHS and the public health and social care services and things like that so what they do is they produce evidence-based guidance so they have gone out they've done the research they've got all of the evidence behind them to produce a guideline so for example for hypertension they've looked at all of the evidence to see what works for hypertension what doesn't work and they've produced a set protocol slash guidance to follow out there in clinics for us so they produce our guidelines protocols quality standards performance metrics all that sort of thing to anyone that works in healthcare public services and social services and these guidelines are really our gold standards this is what we use to justify our reasoning behind why we're doing something so if I've got a patient that's coming for their blood pressure and I've followed all of the guidance I've done everything I can then I'm covered I can justify my actions I've gone by evidence-based research because I've followed the nice guidelines and all of that jazz so it's just a way that covers yourself as well because as healthcare professionals we are following evidence-based practice to get better outcomes for our patients that's just the way we do things now searching the website can be horrific I'm not going to lie I have looked up a few things and I can't find certain things I've had to email them and just say listen I'm looking for a specific set of guidelines for something any dangers of just pointing me in the right direction and showing me where I'm going wrong so please don't worry if you can't find something that are helpful useful numbers it's on the website as well just go to the contact section on the nice website and send them an email if you can't find something so this page right here is your main nice page when you google nice guidelines this is your main page okay and then at the top you've got guidance so if you click that it's got all different topics that you can search for health protection population groups anything you want to look for basically under those sort of topics you've got nice pathways up the top so look for different pathways that you want to find so again I'm using hypertension because it's the easiest one to explain and so just have a look at that so I'm clicking on hypertension here and then it should come up somewhere oh here you go hypertension there you go and that just shows you your pathway for hypertension and then it's got all of these links that you can click on as well and then it'll take you to a different a different page a different pathway if you if you if you like and then along the side here it's got all the different managing treatment hypertension and pregnancy which i've just clicked on um but that's just that's quite an easy way to do it to be honest um otherwise there's at the top as well there's different quality standards you can look for life signs so I haven't used any of these to be honest the bnf we love the bnf um what's this one oh bnf for children obviously bnfc uh cks what is cks I don't know what cks stands for about cks here you go let's click on that oh clinical knowledge of clinical knowledge summaries okay cks I didn't know that um anyway so let's go back to the main page so you've got your main home page if you just want to quick search something uh you can literally just type it in the top so again I'm going to use um hypertension because it's easy click in hypertension and then you'll get a whole load of results 384 results but on the left hand side you can cut it down so if you go on guidance pathways whatever you're looking for you can cut it down on the left hand side there um but I'm looking I normally do diagnosis and management that's the one I'm mainly aiming for because in clinic I want to know how to manage my hypertensive patients um and it's got tools and resources on this page so um all these different assessment tools and things like that that you can go on it is quite a lot of information so don't worry about that too much right now just remember your nice home page search whatever topic you want to search for um and just go go from there so down here it's got diagnosing starting treatment we don't need that because we don't diagnose I'm going to not start in treatment so for me it's monitoring treatment and blood pressure targets that's my main area of concern so this shows you all of the recommendations for people with hypertension what your target should be but also it factors in the different uh conditions as well so if someone's got diabetes uh for example they're going to have different targets to just a regular healthy person that's got hypertension if that makes sense um and this just shows you what you should be doing this is the gold standard evidence-based practice what you should be doing in clinic it's quite a lot of information there's lots of different links and lots of different guidelines included um so it can be a little bit overwhelming sometimes looking on these nice guideline pages but once you get your head around it and I think that's the main thing with nice guidelines get your head around it and keep practicing keep searching don't just look at it and think I can't do this and just click off and switch off because we have to follow nice guidelines whether you like it or not it's what we have to do unfortunately so yeah so just getting your head around the website just practice you can't go wrong whatever you click on or whatever you know you're not going to suddenly set off some sort of crazy internet explosion or do something crazy so don't worry too much just get used to this website um and you'll be well away honestly it is just just practicing and taking the time to get used to the website and the ways of doing things sorry I've got like a tag on my t-shirt and it's itching my back so sorry about that um what else another really good thing that's on here that I want to point out is decision aids so again if you go on to the page that you want you go up you search hypertension for example or diabetes asthma asthma is a really good one as well um have a look at the decision aids the decision aids are here so this is what you'll see in front of your patient with and and it brings up things like this so how do you control your blood pressure as a patient so this is a really good decision aid so it shows you what it is what does the blood pressure mean it then says okay what are my options what can I do about my blood pressure so it will give you all of these different options um and then have a look at this table that there's normally a table that says okay what does this do why does it do it how's it going to help what are the advantages all that jazz hopefully is going to persuade your patient to do something about their health um and then it's got different things like medicines that will come up as well same with asthma it's got all the different um different inhalers and things like that that they can take and there's a different sort of decision aid for that and it depends on very much whether like some people have got arthritis in their hands or whether they can push down on on the device so what device are they going to have little things like that it's just really good for this sort of stuff it's absolutely amazing um so this table is really really good as well so it's got all these different choices what what happens and then it shows you all the chances of side effects this is really really good to sit down with your patient obviously you have to have the time as well to do this and make sure they're giving you time in clinics as well so this is just showing you side effects and things like that in a table it's just it's really really good really helps your patient understand the condition as well so use it and abuse it for your patient so now i'm just going to show you a different condition so we're going to go back to our nice page we're going to search asthma just to show you asthma because that's another easy one click asthma and then once you're clicking to any asthma thing it'll come up guidance it's got the pathways again it's got all of this nice guidelines anything you want to um search basically on asthma so new in the last six months what have we got this shows you um more the evidence side of things so when you look at this sort of guidance and stuff like that it goes into different conditions and different treatments and different managements and things like that so it can be a bit confusing when you click on this sort of page because you're like i don't know what i'm trying to look for but if you just start with the basics asthma i click onto this one so that asthma diagnosing monitoring and management of asthma obviously i'm not going to be diagnosing i'm not a nurse prescriber i'm not advanced with nurse practitioner anything like that i'm not going to be dealing with any of that so mine is just monitoring and management of asthma that's what i want to know oh this is really weird page okay ignore everything i've just said ignore that i'm going to go up top here because that's a really weird page asthma and click on this diagnosis monitoring asthma there you go that should bring up the page now there you go thank you so this is the page that we wanted and this is where nice guidelines get confusing because there's so many different pages but you literally just keep searching for what you need so again for me for asthma i can look at the initial assessment because that's what we do as nurses as well we can assess it but we're not putting a diagnosis on it we're just taking all of the history all of the symptoms things like that to be able to think okay this could potentially be asthma and then you co co i don't know what i was going to say then you liaise with your doctor or GP or your advanced nurse practitioner say listen this is what i've found from this patient i think they've got asthma what do you think and you work together to be able to get that diagnosis and then the advanced nurse practitioner or the doctor will then give that official diagnosis you don't do that because we don't do that as nurses so this one again uh initial assessment you want to take the history like i said physical examination which i can't do as a nurse but again the advanced nurse practitioner can and the doctor can so they'll do like chest examinations and that sort of thing to listen for a wheeze in the lungs um physical examination as well so then again monitoring asthma so this is what we're doing in the asthma review so it's shown you step by step what they need and they come up with these list of things that we should be doing to help prevent like an asthma attack from happening it's not always going to be the case you won't always prevent an asthma attack but just by all of the research and the evidence that they've found putting these things in place can really really make a massive difference to somebody's asthma and control so it's getting that control for the patient so these are all different things so they've got that asthma control questionnaire if you google act asthma it'll come up and you'll see the sort of questions that they ask on that this is really really good to gauge sort of your patient symptoms and stuff like that then you've got all these different doses so again we're not doing inhaler dosing or anything like that it's down to the doctor to prescribe and then uncontrolled asthma and suspected and all that there's absolutely loads I could spend all day going through all of these guidelines um but it's literally once you get your head around it it's not too bad sometimes you end up on pages and you're just like I have no idea how I've ended up on here but literally just go back to the start click back to the start main page and just search or just go on to nice pathways like I said and just look for the particular topic that you want down on this little table here really really good yes so I hope that's been some sort of help on nice guidelines I'm sorry it's not really in depth or anything like that but literally again you just need to practice you need to just get your head around the website that is the main bit and just keep clicking on links like if you'd not find a new link just have another go so I hope that's helped in some way with nice guidance if there's anything else you want to know just drop a comment below I will try and answer it but again I'm not 100% the best at nice guidelines myself but things like hypertension diabetes asthma the standard things are always there clear as day 101 different things for it um it's just searching through the different links and stuff like that to find what you actually need which can be tricky but like I said just keep going at it keep practicing and hopefully you'll get there so thank you so much everyone for taking the time out to watch this I hope it's been a benefit and I hope you have an amazing week